CULTURE SHOCK

Lt Pat DeConcini ANGRC/SE Andrews AFB, MD

The Combat Edge (Jan 95)

In The Beginning that the program had merit, so we decided to continue.” It is now two years later and the In October of 1992 Major General Shepperd, program has been taken to almost 50 Air Director of the Air National Guard, called National Guard units and one Army his Director of Safety, Col Nielsen, and National Guard unit. After each visit, a asked him to attend a briefing given by Lt survey is given to the unit commander with Col Groben, a maintenance officer who had the results mailed to the ANG safety office. served on four Class A mishap investigation Col Nielsen says: “Most of the surveys boards. A group of senior officers listened contain comments such as:” ‘best program as Groben explained a unique theory he had yet for the units,’ ‘every unit needs this developed about mishap prevention. Col program,’ ‘thanks for a program that is for Nielsen recalls, “For many at the briefing us.’ The units realize that this program is this was a completely different approach that for them to assess their unit culture. The was outside the normal acceptable results are confidential and are not given to boundaries of mishap investigation.” anyone outside the unit including the ANG Nielsen and the others listened cautiously as safety office which sponsors the program.” Groben explained that many recent mishaps Nielsen attributes much of the success to the occurred not because an individual forgot to non-retributional nature of the program and perform a required inspection or a pilot gives great credit to Gen. Shepperd for his violated a regulation or procedure. Instead, long-term vision and ability to see beyond he argued, there were dysfunctional unit the present paradigm. Nielsen explains: “A cultures that allowed the errors to happen, program like this exemplifies the quality and these cultures were the root causes of principles that tell us to step outside of our the mishaps. Nielsen remembers: “I was a normal boundaries and imagine new ways of little skeptical at first, but I kept listening; doing business. We know that if we take and the more I heard, the more it made sense chances on a program of this type it could to me. After the briefing we decided that if fail, but if we are unwilling to accept that we really have a true quality environment, failure is possible, we will limit our growth we should at least examine the idea and see and learning. Sometimes risk and what our customers in the field think.” uncertainty are necessary to provide for a continually improving organization. It was agreed that the ANG safety office would take on the project to evaluate its What’s In A Name? potential. Nielsen sent Groben to two volunteer units to evaluate their cultures. In the early stages of the mishap prevention Nielsen explains: “We then surveyed these workshop, many commanders provided units and found out that the program was feedback indicating that the name, Accident very well received. Gen. Shepperd agreed Prevention Paradigm Workshop, was inadequate and misstated the scope and descriptive of the processes and results impact of the process. As a result of this which are creating a shift from the feedback, Lt Col Groben adopted a new traditional compliance view of safety to one name and the following foundation with culture as a root issue. statement: “An effective safety program must exist on a foundation of Integrity, Trust Pitfalls and Leadership created and sustained by effective communication. The name of the The lights are on, but no one’s home. The program is: The Leadership Culture existing system makes the commander Workshop. Groben says, “While integrity is responsible for safety, with a Chief of Safety the bedrock of a sound safety program, to implement and manage the program. communication is the medium through Groben describes: “The right person for this which integrity is created.” the workshop job is someone who demonstrates integrity. examines the existence of trust, integrity, The effect of filling this position with the leadership and effective communication in wrong person is importent from a cultural an organization. The workshop results are aspect. Because of the high visibility of this the culmination of a deep inquiry into the position, unit personnel are aware of the workings of the unit far beyond the scope of actual performance of the Chief of Safety. traditional safety oriented examinations. Unit members, both enlisted and officer, see Traditional avenues of review are essentially what’s happening and make judgments compliance based. That is, does a unit do about what the commander perceives as a what they’re supposed to do, and do they priority and what he/she does not. These refrain from doing what they’re not judgments essentially run along the lines of supposed to do? The workshop process does “If it’s not important enough to place a not focus on these compliance issues. competent, capable person as chief of safety, Rather, it examines the foundation of safety is not very important.” As Groben compliance which is integrity. Groben explains: “The failure of commanders to explains: “The issue then shifts from what install an accountable and capable individual was done wrong, to why did it really as chief of safety constitutes a breach of happen? That is, what systemic or integrity readily visible to all unit personnel. attitudinal deficiencies exist that allowed the That breach spreads and becomes the anomaly to occur, and could those standard for the unit. If problems channeled deficiencies rear their ugly head again if not through the safety office are not handled properly resolved?” It only takes one breach properly, the culture of safety in the unit will of integrity when “no one’s watching” to deteriorate. Safety as an effective culture in overshadow hundreds of successful the unit will be diluted because the Stan/Eval and QA performances. There are commander did not create a culture that several recent examples where the root places emphasis on it. Saying safety is cause of the mishap was that the crew did important will not produce the foundation not fly what they said they would fly, for an effective safety program. Actions that constituting a breach in integrity. Groben mirror those words will.” claims that current Safety Investigation Board (SIB) guidelines and procedures do Leadership Style And Transition not address this fundamental issue - leaving the door open for repeats. The current Establishing the right culture many times name, The Leadership Culture Workshop, is means altering the existing culture, and change of any kind is often resisted. The existing behavior patterns, it can be culture of a unit may have developed over extremely difficult to dislodge many years and its roots may be very deep. institutionalized behavior patterns. On the other hand, some unit cultures are newly developing, undefined, or just not In order to change the culture, the unit entrenched as deeply as others. If cultural members and commander must first identify transition is necessary, it will probably be what the culture is and what type of much easier in the non-entrenched situation. leadership styles exist. This is where the Leadership Culture Workshop comes into Another important factor which may effect play. Lt Col Groben’s system identifies the cultural change is the style of leadership unit culture and leadership styles and which created the existing culture. As with provides a forum for honest and frank cultures, there are many different leadership discussion in connection with mishap styles and different types of leaders. One prevention. leadership style that creates particularly difficult problems for cultural change is the Lt Col Groben believes: “As a commander, fear and intimidation method. This style is the best thing you can do for your unit is to normally associated with micro- create the right culture, one that emphasizes management, arbitrary and capricious trust, integrity and leadership, and deeply actions and a “do as I say, don’t ask why, root it into the very fabric and operation of and like it” attitude. From the commander’s the unit. Then you will know that as time point of view, this style may appear to be goes by and the torch is passed, your legacy effective. However, as Lt Col Groben of professionalism and safety will live on.” explains, this is not always true: “The reflection of this approach eventually begins Essential Elements to manifest itself in negative ways. People stop making independent decisions and seek INTEGRITY. What does this mean to Air approval before acting because they are Force pilots? Integrity is the most important unable to distinguish between situations element because it encompasses the core when approval is needed, and when it is not. values that the other elements revolve Honest opinions are not shared because they around. Webster’s dictionary describes are not well received. Lateral integrity as “firm adherence to a code communication and coordination begin to of...values.” According to Groben, “If a suffer because people are too busy pilot has the opportunity to violate a rule protecting themselves.” The fear and with little or no apparent chance of being intimidation approach permeates the caught, but decides not to because there’s a organization and becomes institutionalized rule prohibiting it, that’s integrity.” In this at all levels. When a leader attempts to example, the reason why the pilot doesn’t transition to a more empowering style, or a break the rule is not because he/she is afraid new leader takes the reins, the inheritance of of repercussions, but because the pilot the old style may remain in place for a long understands integrity and believes in period of time in spite of substantial effort to following the rules. What exactly is the the contrary. Communicating honestly and application of integrity? Why should we creating trust where there was none is follow some training rule that in a situation difficult and risky for the people. Since the really isn’t important or doesn’t apply? path of least effort is to continue with the Because, although the rule might not apply, the value of following rules does. Groben subconscious part of his brain says “don’t uses a hypothetical example and explanation worry, we fly out of MOAs all the time and to make his point. no one even notices.” So, as he turns right and looks over his shoulder for other Squadron pilots regularly violate the bandits, he crashes into a small commuter borders of a particular MOA. ATC doesn’t airliner killing all 18 aboard. The pilot usually complain because airline and ejects and receives a broken ankle on civilian traffic is rarely in the vicinity of the landing and gets to tell the story for the rest border excursions. As a result, when a pilot of his life. Investigators and commanders violates the MOA border, there is little or no completely miss the point and prompt a new peer accountability and no consequence FCIF and training focus on maintaining back at the squadron. In fact, there is no area boundaries. mention about it in the post-flight debrief because, in practice, there is no potential But, as Groben explains: “Area boundaries for harm. As the months and years go by, are not the real issue. The real issue is that pilots in this squadron become accustomed the culture in the squadron allows its pilots to, and unafraid of, frequently violating to become accustomed to violating rules. A MOA borders. Then, while deployed to a philosophy that allows rules to be broken relatively unfamiliar training sight, Capt. O, when it’s ‘OK’ leads to an opportunity to as part of a large package, shows up late to break a rule at each decision point. The the mass brief. He feels bad about being system created that rule for a good reason late, but after all, “some guys are late to and based it on reliable data and real life every brief back home and nothing happens eventualities. When you understand this to them.” Where our nocturnal pilot arrives idea and you follow a rule not because at the brief, he squeezes into the back of the you’re afraid of getting caught, but because room and tries to spot his flight leader. The you understand the ‘big picture,’ local briefer is just finishing a discussion on congratulations. You have INTEGRITY.” local procedure and airspace restrictions as our pilot finds his flight leader and gets all Groben believes integrity by only a few is his paper work. Part of the local brief the inadequate, which is why peer pilot missed was a discussion about the accountability is necessary to ensure all importance of not violating the western members of a squadron have the same boundary of the MOA because airline traffic philosophy. Does this mean we all have to uses it as a transition route into the local become policemen of each other? commercial airport frequently flying very Absolutely not! What it means is that when close to the western boundary of the MOA. you violate a rule, or you see one violated, it is recognized as such and some sort of The mission proceeds as planned and our corrective action is taken. This action might pilot is involved in several multi-bogey only be a short mention in the debrief: engagements. As he pulls off from a guns “Hey, you went a little below your minimum track and prepares to return to his cap release altitude; watch out for that.” Or self point, he realizes that a right turn will be recognition: “I should have called ‘blind’ much shorter than a turn to the left. immediately instead of waiting.” These However, he thinks that if he turns to the small actions by themselves might not right (the short way) he might go out of the prevent a mishap, but the cumulative effect MOA, but he’s not sure. This is where the of demanding the best out of yourself and LEADERSHIP. What does this mean for your peers definitely will. Air Force Pilots? For integrity and trust to exist in a unit the commanders must support TRUST. What does this mean to Air Force and actively promote the right philosophy. pilots? Again, Webster’s dictionary defines If the commander doesn’t demonstrate that trust as “assured reliance on the character, he/she has integrity, the unit is destined to ability, strength or truth of someone or have problems. Groben thinks: something.” As pilots we trust and rely on “Commanders need to personally address each other to carry out certain tasks. and speak with all pilots to explain what Without mutual trust we cannot do our job; integrity means, why it’s important, and it’s that simple. Time cannot be wasted what is expected from each pilot. They must worrying about whether other flight specifically address situations where known members are following the rules. The less violations of training rules happen time wasted on such concerns leaves more frequently and encourage senior pilots to be time available to do our main job. In simple publicly self-critiquing as an example to the terms, the more we trust each other, the new and less experienced flyers.” This will better and safer we fly. Pilots must trust that probably be somewhat difficult for many other pilots will attempt to protect them commanders and senior pilots because of the from harm, give honest and constructive “touchy, feely” nature of it all. Actually, criticism, accept criticism and act like many squadrons have this exact professionals. We need to be able to trust environment; however, it may not be our training, instructors, commanders and, recognized as such and talked about enough most importantly, ourselves. Lack of trust to keep the integrity and trust alive into the can create a nagging feeling of uneasiness distant future. Groben asks: “What’s the which could prove disastrous in the culture in your squadron, and what are you demanding environment of military flying. as a commander doing to change and As Groben states, “Trust comes from improve it? Have you accepted that your proven, consistent, reliable behavior and the unit has a culture? If not, look critically at knowledge that everyone is singing off the how people operate and you will find a same sheet of music; and most importantly, prevailing attitude that explains most of your the knowledge that everyone has integrity.” unit’s failures and/or successes.” Fly Safe!